Obamacare week two - Administration admits to website design problems – ACA ground war won or lost in Texas

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ADMINISTRATION ADMITS TO DESIGN PROBLEMS — The Obama administration has spent the last week pushing its message that Obamacare’s rocky launch is simply due to its overwhelming popularity. But federal officials told The Wall Street Journal yesterday that the exchanges need design changes and more server capacity — and they’re currently making software and hardware improvements to smooth the whole process of signing up. “We can do better and we are working around the clock to do so,” HHS spokeswoman Joanne Peters said. The WSJ story: http://on.wsj.com/17L62sJ

OBAMACARE WEEK TWO: WHAT’S IN STORE? — The exchanges will work a lot better this week — or at least that’s what the administration would like everyone to believe. Healthcare.gov apparently visited the doctor over the weekend, having its application section removed during off-peak hours for “scheduled maintenance.” HHS said Friday that consumers should expect “significant improvements in the online consumer experience.” We’ll be checking it out over our morning coffee.

--A quick update on where last week ended: More than 8 million visitors have visited Healthcare.gov, with one-third accessing educational information and two-thirds accessing the marketplace to begin their application and shop for plans, according to an HHS release late Friday. The agency also said it assigned more technicians to work on the system around the clock and added additional servers.

Welcome to Monday morning PULSE, where we have a great idea for how Republicans can message on Obamacare this week: Try to sign their pets up for the exchanges. Okay, so we have to credit that idea to House Oversight Chairman Darrell Issa, who tweeted on Friday: “Kitteh tried to sign up for #Obamacare. It said no.” Or maybe it was the intern who wrote that. http://bit.ly/17et8Ur

“Once I thought my PULSE was gone, now I know that happiness goes on.”

EVERYTHING IS BIGGER IN TEXAS – The Obamacare ground war will be won and lost in places like Texas, our colleague Jennifer Haberkorn reports from Houston. If a significant number of the 6.1 million uninsured Texans don’t enroll, then the White House could miss its national enrollment targets, the exchanges could falter and insurance rates could spike. That’s exactly what leading Texas politicians like Gov. Rick Perry and Sen. Ted Cruz would like to see happen. But advocates are banking on a grass-roots push in more liberal, urban areas of the state, plus the demand among the uninsured to get health coverage. http://politi.co/18JLccJ

STILL NO WORD ON ENROLLMENT RESULTS — When asked whether the administration is withholding initial Obamacare sign-up results because they’re so small, Treasury Secretary Jack Lew said he doesn’t know the number because it’s not his primary area of responsibility. “My knowing or not knowing is not — is not going to be indicative,” he told “Fox News Sunday” host Chris Wallace.

ACA POSTER BOY NEVER ENROLLED — Remember Chad Henderson, that college student who got a lot of attention last week for claiming that he had enrolled in Obamacare? Turns out he never completed the enrollment process. He was widely acclaimed as a poster child for the exchanges, but now he says he never claimed to have actually purchased a plan. The Pro story: http://politi.co/18JLkcf

CO-OP PLANS COULD BE LOWERING COSTS — States with the new member-owned CO-OP health plans have premiums more than 8 percent lower than states without them. They’re intended to increase competition on the exchanges — and there’s some early evidence that they’re helping to lower costs, according to an analysis commissioned by the National Alliance of State Health CO-OPs. The Pro story: http://politi.co/17NaiYU

** A message from AHCA. As Congress mulls options to pay for the doc fix this year, skilled nursing and assisted living providers have smart policy alternatives that lower Medicare costs without cuts. We are AHCA. And we are the solution. Learn more at http://ahcancal.org/solutions. **

WHILE YOU WERE WEEKENDING

--Boehner said on ABC’s “This Week” that he lacks votes both for a clean CR and for a clean debt ceiling increase (meaning the bills don’t defund or otherwise block the ACA).

--While some reports had suggested Boehner privately intended to bring a clean debt ceiling increase to the floor, now he says the votes aren’t there. “I told the president, there’s no way we’re going to pass one,” he said. “And the president is risking default by not having a conversation with us.”

--Texas Sen. Ted Cruz took to CNN’s “State of the Union” yesterday to urge Republicans to demand changes to the ACA in return for raising the debt ceiling. “The debt ceiling historically has been among the best leverage that Congress has to rein in the executive,” he said. More: http://politi.co/GGNRLt

--In his weekly address, President Barack Obama reiterated that he won’t give in to Republican demands to dismantle or tweak the Affordable Care Act.

CORNYN: DEMS FORCING SHUTDOWN FOR POLITICAL POINTS, NOT ACA — Shocker: Republicans used their Saturday morning radio address to bash Obamacare, again. It was delivered by Sen. John Cornyn of Texas, who criticized Democrats for refusing to negotiate on the law in a funding bill while arguing that his party is “eager” to reopen the government. He claimed the Dem’s are motivated not by a desire to keep the ACA funded — but to leverage political points from the shutdown. More for Pro’s: http://politico.pro/1bBmyj4

OHIO ON THE VERGE OF MEDICAID EXPANSION? — Ohio could expand Medicaid in days or weeks, not months, senior lawmakers on both sides of the aisle tell Pro’s Kyle Cheney. Once the Republican-controlled legislature decided to go ahead with it, Gov. John Kasich could essentially flip an “on” switch, built into the state’s Medicaid eligibility system. Leaders in both parties say expansion makes logical sense and the political players are ready. But in case that never happens, there’s still lots of chatter about a method Kasich could use to expand the program while bypassing the legislature. The Pro story: http://politico.pro/17aLQNA

PAPER APPLICATIONS AREN’T DISAPPEARING — Let’s face it: Some people are still going to sign up for the health exchanges using paper applications, instead of going online — even before their glitch-filled launch. Of course, advocates are pushing online applications, since they’re a lot easier to complete, require fewer steps and catch errors better. But the Obama administration has still been preparing for a crush of paper, awarding a $1.2 billion contract to Serco for processing 6.2 million paper applications during enrollment period. The Pro story: http://politi.co/1bCncNp

HAPPENING TODAY

--The House gavels back in at noon and will vote on a bill funding the FDA — the latest in its series of piecemeal bills funding parts of the government. The bill: http://1.usa.gov/1fbGN7M The Senate is back in at 2 p.m.

--Extra reason to watch The Daily Show tonight: HHS Secretary Kathleen Sebelius will be a guest, talking about how the launch is going. We can’t wait to see what kind of exchange-related humor Jon Stewart comes up with.

--Members of the American Academy of Pediatrics are visiting members of Congress to tell them how the government shutdown is hurting children by blocking funding for the CDC’s flu program, new clinical trials at the National Institutes of Health and other programs. We’re sure they’ll convince Congress to end the madness … or not.

HAPPENING THIS WEEK

--The House Oversight Committee has scheduled a 9:30 a.m. hearing Wednesday on the IRS’s operational challenges in implementing the Affordable Care Act — like collecting new taxes and paying out insurance subsidies. http://1.usa.gov/1gi9fnn

--At 1:00 p.m., the House Small Business Subcommittee on Health and Technology will hold a hearing on how the law’s definition of full-time employee is affecting small businesses. http://1.usa.gov/18IIcxp

MIXED RULING ON DRUG COMPANIES’ SECRECY FIGHT — Two drug companies want to keep hidden reports they submit to the government detailing possible law violations by their employees. A federal judge has delivered a mixed decision on Friday, saying that some of the information must be released to Public Citizen — which sued for the information — while some compliance information can still be kept secret. HHS joined the side of Pfizer and Purdue Pharmaceuticals in the lawsuit. The POLITICO story: http://politi.co/1a7MH3P

LOBBYIST ACCUSES NBC OF SHILLING FOR ACA — Time Warner lobbyist John Lively accused NBC and other broadcasters of shilling for the health law, in an email to Republican staffers — and Rep. Henry Waxman says he crossed a line. “Could you please explain why this email was sent and what purpose it serves?” Waxman wrote to Time Warner CEO Glenn Britt. The company has said it will get back to Waxman with an answer. Waxman’s letter: http://politico.pro/1bxkicM

SHOOTING PROMPTS CALLS FOR MENTAL HEALTH LEGISLATION — Last week’s shooting on Capitol Hill involving a woman believed to have post-partum depression prompted some calls for mental health-related legislation. Rep. Tim Murphy, Energy and Commerce Oversight Subcommittee chairman, said he’ll introduce legislation focused on boosting treatment options in the next few weeks. And Sen. Debbie Stabenow (D-Mich.) called on Congress to pass her “Excellence in Mental Health Act,” which she’s been pushing since last spring.

QUESTIONS ON OBAMACARE? – Join David Nather, author of POLITICO’s “Understanding Obamacare” guide, and the POLITICO Pro health care team this Wednesday at 1:30 p.m. on Twitter with hashtag #ProChat to talk all things ACA.

WHAT WE’RE READING

If the Obamacare enrollment process gets smoother, the unexpected initial surge of customers could end up being the most important story to emerge from the exchanges’ first days, the L.A. Times writes. http://lat.ms/197sr1Z

Reuters interviewed five technology experts who said they believe the problems were caused by flaws in system architecture, not just traffic. http://reut.rs/179JBcw

Obama’s chief technology advisor tells USA Today that the website was overwhelmed by possibly five times as many users as it was set up to handle. http://usat.ly/1fQKKzT

Major pharmaceutical companies paid hundreds of thousands of dollars to fund a scientific panel that shaped the government’s policy for testing the safety of the painkillers they produce, according to The Washington Post. http://wapo.st/18INMQe

Despite critics’ dire predictions, exchange competition is “robust,” especially in markets where Republican-leaning states decided against operating their own exchanges, Bruce Japsen writes for Forbes. http://onforb.es/15PIBjq

Slate Magazine’s David Weigel gives us a timeline of how the “defund Obamacare” movement started: http://slate.me/1aTMGBm

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